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Parenchyma-sparing hepatectomy (PSH) versus non-PSH for bilobar liver metastases of colorectal cancer

Spelt, Lidewij LU ; Ansari, Daniel LU ; Swanling, Max; Holka, Peter and Andersson, Roland LU (2018) In Annals of Gastroenterology 31(1). p.115-120
Abstract

Background Preoperative interventions have increased the resectability of colorectal cancer (CRC) liver metastases. This retrospective study compares outcomes after liver resection for bilobar CRC metastases between patients who underwent parenchyma-sparing hepatectomy (PSH), i.e., segmentectomies and smaller resections on both lobes, and those treated with non-PSH, i.e., hemihepatectomy plus any resection on the other lobe. Methods A cohort of 119 patients who underwent liver resection for bilobar CRC metastases were included. Perioperative course and long-term survival were compared between 59 patients who underwent PSH and 60 patients who underwent non-PSH. Statistical analyses were done using Pearson’s chi-square test, Fisher’s... (More)

Background Preoperative interventions have increased the resectability of colorectal cancer (CRC) liver metastases. This retrospective study compares outcomes after liver resection for bilobar CRC metastases between patients who underwent parenchyma-sparing hepatectomy (PSH), i.e., segmentectomies and smaller resections on both lobes, and those treated with non-PSH, i.e., hemihepatectomy plus any resection on the other lobe. Methods A cohort of 119 patients who underwent liver resection for bilobar CRC metastases were included. Perioperative course and long-term survival were compared between 59 patients who underwent PSH and 60 patients who underwent non-PSH. Statistical analyses were done using Pearson’s chi-square test, Fisher’s exact test and the Mann-Whitney U test. Overall survival analysis was performed by the Kaplan-Meier estimator and Cox regression analysis. Results The median number of liver metastases was 2 in patients treated with PSH and 3 in those treated with non-PSH (P<0.01). Postoperative mortality, severe complications and radicality did not differ significantly between groups. Median intraoperative bleeding was 250 mL for PSH and 600 mL for non-PSH (P<0.001). Median operation time and hospital stay were significantly shorter for PSH. Overall survival was comparable between groups, also after adjustment for covariates. Conclusions There were no significant differences in outcome, except for differences in bleeding, operation time and postoperative stay, favoring PSH. Furthermore, minimizing resection did not influence radicality. Hence, this study supports the use of PSH for bilobar CRC liver metastases when possible.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bilobar disease, Colorectal cancer metastasis, Liver resection, Parenchyma-sparing
in
Annals of Gastroenterology
volume
31
issue
1
pages
6 pages
publisher
Hellenic Society of Gastroenterology
external identifiers
  • scopus:85040464664
ISSN
1108-7471
DOI
10.20524/aog.2017.0205
language
English
LU publication?
yes
id
4713ce30-fd8a-4c36-b823-f48010b3d040
date added to LUP
2018-02-23 19:09:38
date last changed
2018-05-29 11:35:38
@article{4713ce30-fd8a-4c36-b823-f48010b3d040,
  abstract     = {<p>Background Preoperative interventions have increased the resectability of colorectal cancer (CRC) liver metastases. This retrospective study compares outcomes after liver resection for bilobar CRC metastases between patients who underwent parenchyma-sparing hepatectomy (PSH), i.e., segmentectomies and smaller resections on both lobes, and those treated with non-PSH, i.e., hemihepatectomy plus any resection on the other lobe. Methods A cohort of 119 patients who underwent liver resection for bilobar CRC metastases were included. Perioperative course and long-term survival were compared between 59 patients who underwent PSH and 60 patients who underwent non-PSH. Statistical analyses were done using Pearson’s chi-square test, Fisher’s exact test and the Mann-Whitney U test. Overall survival analysis was performed by the Kaplan-Meier estimator and Cox regression analysis. Results The median number of liver metastases was 2 in patients treated with PSH and 3 in those treated with non-PSH (P&lt;0.01). Postoperative mortality, severe complications and radicality did not differ significantly between groups. Median intraoperative bleeding was 250 mL for PSH and 600 mL for non-PSH (P&lt;0.001). Median operation time and hospital stay were significantly shorter for PSH. Overall survival was comparable between groups, also after adjustment for covariates. Conclusions There were no significant differences in outcome, except for differences in bleeding, operation time and postoperative stay, favoring PSH. Furthermore, minimizing resection did not influence radicality. Hence, this study supports the use of PSH for bilobar CRC liver metastases when possible.</p>},
  author       = {Spelt, Lidewij and Ansari, Daniel and Swanling, Max and Holka, Peter and Andersson, Roland},
  issn         = {1108-7471},
  keyword      = {Bilobar disease,Colorectal cancer metastasis,Liver resection,Parenchyma-sparing},
  language     = {eng},
  number       = {1},
  pages        = {115--120},
  publisher    = {Hellenic Society of Gastroenterology},
  series       = {Annals of Gastroenterology},
  title        = {Parenchyma-sparing hepatectomy (PSH) versus non-PSH for bilobar liver metastases of colorectal cancer},
  url          = {http://dx.doi.org/10.20524/aog.2017.0205},
  volume       = {31},
  year         = {2018},
}